Only Mild Improvement in Medicine / Internal Medicine — 32yo Man | Gastroenterology | SMLE Q#11206
SMLE Question #11206
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 32-year-old man has 3 years of heartburn and regurgitation, worse after large meals and when lying flat. He reports good adherence to a twice-daily proton pump inhibitor taken before meals for 8 weeks, with only mild improvement. Upper endoscopy last week was normal, with no esophagitis or Barrett esophagus. His physician wants objective evidence of reflux before considering invasive therapy or alternative diagnoses. What is the most appropriate next step in management?
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